结肠镜与多层螺旋CT在肠梗阻诊治中的价值

Evaluation of colonoscope and MSCT in the etiological diagnosis of fleets

目的探讨结肠镜、MSCT和MRI在肠梗阻诊断中价值。方法回顾性分析140例经腹部平片、手术证实肠梗阻病人的结肠镜、MSCT资料并复习有关肠梗阻MRI诊断文献。结果140例肠梗阻：结肠梗阻60例，小肠梗阻73例，未明确7例。结肠镜检查67例：其中结肠肿瘤41例；结肠息肉6例；结肠套叠6例；乙状结肠扭转2例；回肠末段肿瘤2例；未见异常10例。MSCT检查80例：其中小肠粪块24例；粪石2例；肠腔外淋巴瘤4例；肠系膜血栓形成1例；小肠肿瘤26例，原因未明23例。治疗情况：保守治疗30例，结肠镜下乙状结肠扭转复位2例；肠套叠空气灌肠复位3例；内镜下结肠息肉高频电切除术6例；手术治疗99例。死亡5例；康复135例。结论结肠镜、MSCT和MRI检查能较为准确诊断肠梗阻病因及其梗阻部位，为临床制订治疗方案提供重要依据。

Objective To explore the value of electronic colonoscope, MSCT and MRI in the etiological diagnosis of intestinal obstruction. Methods The clinical data of 140 ileus patients were retrospectively studied. Results 140 cases of ileus included 60 cases of colon ileus, 70 cases of small intestines ileus and 7 indefinite cases. 67 cases were checked with colonoscopy, among them, 41 cases with colon tumors, 6 cases with colon polypi, 6 cases with colon set folds, 2 cases with sigmoid colon turned round, 2 cases with ileum tumor and 10 cases with unknown reason. 80 cases were checked by MSCT checks, among them, 26 cases with small intestines tumor 24 cases with small intestines muck piece, 23 cases with unknown reasons, 2 cases with muck stone 2, 4 cases with bowel chamber outside lymphoid lump, 1 case with bowel fastens film blood to bolt. 30 cases were kept to cure. 2 cases were turn round to reset under the colonoscopy, 3 cases were set folds air to infuse bowel to reset, 6 cases with inside the mirror descend colon polyp were resected with high frequency electricity resection. 99 cases were cured by surgical operation. 5 cases were dead and 135 cases were recovered from illness. Conclusion Electronic colonoscopy, MSCT and MRI checking are accurate methods to diagnose why and where of ileus, and which establish importance basis for clinical treatment.